Objective: The purpose of this article is to study the added value of model-based iterative reconstruction (MBIR) on metal artifact reduction on CT compared with standard filtered back projection (FBP).
Materials and methods: Ex vivo imaging was performed on several metal implants. Datasets were reconstructed with standard FBP and MBIR algorithms. The sizes of the artifacts surrounding the metal implant were recorded and compared. In vivo imaging was performed on 62 patients with metal implants. Each dataset was reconstructed with FBP and MBIR algorithms. Objective image quality was assessed by measuring the size of the artifact generated by the metal implant. Subjective image quality was graded on a 3-point scale, taking into account the visibility of the bone-metal interface, as well as the visibility of the neighboring soft tissues.
Results: Ex vivo analysis yielded a reduction of 82% in the size of the artifact when using the MBIR algorithm, compared with the FBP algorithm. The mean (SD) size of the artifacts was 1.4 ± 0.8 and 0.25 ± 0.06 cm(2) with FBP and MBIR, respectively. In vivo, the mean size of the artifacts decreased from 7.3 ± 1.5 cm(2) to 4.0 ± 0.9 cm(2) for FBP and MBIR, respectively (p = 0.012). The subjective image quality analysis showed an equal or better bone-metal interface of MBIR algorithm in 85% of cases. Visibility of the soft tissue surrounding the metal implant was determined to be equal or better in 97% of cases in which MBIR was used.
Conclusion: This study shows that the MBIR algorithm allows a clear reduction of metal artifacts on CT images and, hence, a better analysis of the soft tissue surrounding the metal implant compared with FBP.
Keywords: CT; metal artifact reduction; model-based iterative reconstruction.